Jeremy Rivera sits down with Len May of EndoDNA.
Len May — CEO and co-founder of EndoDNA, a genetics-first decision-support platform for healthcare practitioners, holder of 11 patents — argues that mainstream “healthcare is really sick care,” a cookie-cutter, insurance-reimbursed system that treats symptoms in 15-minute visits instead of root causes. His alternative starts with reading an individual’s DNA, layering on bloodwork and epigenetic (methylation) markers, and building a precise, personalized protocol across three levers: pharmaceutical intervention, supplements, and lifestyle. A former dispensary owner who got into genetics after watching two people react differently to the same cannabis varietal, May explains the endocannabinoid system, why THC has a “narrow therapeutic window,” and how genetic predispositions explain both cannabis’s benefits and its adverse reactions. He is a fierce advocate for patient accountability and for federal quality-control standards on a cannabis industry he calls “the most regulated unregulated industry that we have.” Woven through is EndoDNA’s use of a health-grounded LLM (built on Anthropic’s health model) that lets doctors “interrogate the genome” in eighth-grade language while keeping AI hallucinations in check.
Genetics first, then a feedback loop
EndoDNA is a decision-support platform for healthcare practitioners built on the belief that everyone is different, so care should be precise and personalized. The method: look at DNA (genetic predispositions), then all the bloodwork (which only captures “a moment in time”), then build a specific protocol. The best way to know a protocol is working is a feedback loop combining patient-reported outcomes (“how I feel”) with biomarker/epigenetic changes — measuring what’s been methylated or un-methylated (turned on/off) — and then AI adjusts the protocol so it gets more personalized over time.
Methylation as a circuit breaker
Asked to explain methylation without getting “geeky and sciency,” May says we’re born with most genes not in the “on” position — like a big circuit breaker where only 20-30% of switches are flipped (skin color, hair color, eye color). Lifestyle sends messages to the cell to create proteins that turn genetic coding on or off. Three big controllers: food (“what we put in our bodies”), environmental exposure (pesticides, heavy metals, microplastics, chemicals), and — the one people don’t understand — neurochemistry/stress. Chronic stress firing off when “there’s no lion chasing you in the jungle” can flip epigenetic switches.
“Healthcare is really sick care, and it’s really cookie cutter approach. And what we believe is that we’re all individuals… all different and healthcare should be done specifically precise and personalized to the individual.”
Len May
The stress → elbow pain chain (root cause)
A car nearly hits you: dopamine, adrenaline, norepinephrine, and cortisol flood your bloodstream, then reuptake and new neurochemicals restore homeostasis — including an endogenous endocannabinoid. But if you have a genetic predisposition to an enzyme that breaks down anandamide faster than average, cortisol lingers, the immune system overreacts to nothing, and you feel inflammation and pain — say, in your elbow. The doctor treats the elbow (the symptom); the root cause was stress and metabolism. If you’re also predisposed to gut issues like IBD, that overactive response can methylate/turn on the gut condition, and now you’re treating a gut that “didn’t really start in your gut.”
Sick care economics and the 15-minute visit
There are two healthcare systems. The insurance-based sick-care system (managed by pharma, FDA) reimburses a 15-minute visit at a higher per-minute rate than an hour with a patient — incentivizing a cookie-cutter approach. He recounts taking his college-bound daughter for a required doctor’s-note visit: heart, lungs, glands, “are you going to break out the mallet and hit her knee as well?” — “it’s 1950s.” We’re partly accountable too, because we’re “pain averse”: a doctor numbing the symptom satisfies the Hippocratic oath and “everybody wins — wrong,” because nobody asks what’s causing the pain. EndoDNA’s customers are cash-based functional/integrative practitioners focused on prevention and root cause.
Doctors asking the genome “dumb questions”
May defends doctors — it’s an enormous amount of information and largely on-the-job training, except “you’re dealing with life and death.” After giving a talk to a room of doctors that met with crickets, he got a flood of texts and emails 30 minutes later — they didn’t want peers to hear a “dumb question.” So EndoDNA built an LLM (patent: “machine learning based efficacy predictions based on genetic and biometric information”) that lets a doctor interrogate the genome — “Show me how Len metabolizes,” “Show me any other genes I should be aware of” — with answers in eighth-grade language, making the patient a partner in their own care.
Guardrails against AI hallucination
Responding to Jeremy’s marketing-side experience with LLM hallucinations, May cites a doctor at the A4M longevity conference who now spends half his practice fixing bad ChatGPT protocols other doctors handed patients (“ask it the same question three times, you’ll get three different answers”). EndoDNA grounds its LLM on Anthropic’s health model (guardrails because it’s health-focused), writes its own guardrails/prompts, lets it self-train on HIPAA/GDPR de-identified data, and further trains it on each individual practice (e.g., a unique peptide stack). May is candid: “I’m not the techie. I didn’t write it.”
The endocannabinoid origin story
May’s first genetic test was for the endocannabinoid system, and he holds a patent on using DNA to make endocannabinoid-related recommendations. The endocannabinoid system — discovered in 1992 by Israeli scientist Dr. Raphael Mechoulam (who “passed away I think 2024”) — has “nothing to do with smoking weed”; it’s an endogenous system that maintains balance and homeostasis, signaling up the central nervous system “like salmon swimming upstream.” The brain releases two key endocannabinoids: anandamide (“ananda means bliss in Sanskrit” — the runner’s high) and 2-AG. When deficient, the plant helps: decarboxylated THC binds CB1 receptors (mostly brain/CNS), CBD has affinity for CB2 (immune/digestive). Like cocaine and dopamine, “it’s just a ligand” triggering our own neurochemistry.
THC’s narrow therapeutic window and adverse reactions
Delta-9 THC has a narrow therapeutic window: the right amount subsidizes a deficiency, but too much creates “a free radical of anandamide” and immune overreaction. Those predisposed to stress reactivity/PTSD can feel anxiety; those predisposed to mood conditions can have them triggered. Potency has exploded — from “Mexican dirtweed with seeds and stems” at maybe 7% THC to 70% THC products today, “completely unnecessary.”
Addiction genetics and the grandma-at-chemo case
There are specific dependence genes (alcohol, opioid, amphetamine) that, combined with impulsivity genes, are “a formula for a disaster.” Cannabis is not physically addictive but can be a mental crutch; “sugar is probably more addictive than caffeine than cannabis.” The case study: “Grandma Mary” hallucinated during chemo and warned everyone to “stay away from devil’s lettuce.” Her DNA test showed she was a poor metabolizer, so a gummy (first-pass through the liver) plus high isolated THC was the wrong call. Switching to sublingual/buccal delivery (bypassing the liver), lower THC/more CBD, and the right calming terpene (linalool, found in lavender) worked so well she started handing out EndoDNA’s business card to other chemo patients.
The tequila analogy for accountability
“The only substance that we do this with”: if you drink too much tequila and feel terrible, nobody calls the tequila company — “you overdid it.” May finds it fascinating that we point fingers at cannabis when, like anything else, adults are accountable for how much they take in.
Regulation: the most regulated unregulated industry
As a former California dispensary owner (under a “not for profit” medical program he found bizarre), May believes in both medical benefits and adult freedom — but insists on regulation, specifically testing. Unlike a bottle of vitamins with a regulated, stamped label consistent across states, cannabis has no federal testing standards (“for CBD, forget about it”). He wants federal quality-control oversight, prescribable cannabis tinctures, and collaboration with pharma to create condition-specific formulations without spending “billions of dollars and 10 years” for FDA approval of substances “used for thousands of years.”
The immigrant grandfather and the mission
May was born in Lithuania and came to the US as a child. His grandfather, “a very physically large man,” suffered multiple strokes; May will never forget his mother and grandmother at the table “with bags full of prescription medications,” constantly chasing contraindications and side effects — which made him scared of prescription medication. His mission (“I’m not a soapbox guy”): be accountable for your own healthcare journey, understand your genetic predispositions, and work in partnership with your practitioner to prevent conditions and address root causes. Even with a predisposition like APOE4 (Alzheimer’s), you can act — omega-3s, avoiding amyloid-plaque-forming foods, exercising the brain for neuroplasticity — rather than “eat McDonald’s every single day.” —
“Your DNA is your life’s GPS. It shows you where your potential potholes and where your traffic jams are in your own road, so by understanding this you can take specific actions to avoid those potholes.”
Len May